NURS 8201 WEEK 10: ASSIGNMENT 2 ARTICLE CRITIQUE
Article Critique
Patients with severe mental disorders, such as major depressive disorder, bipolar illness, and schizophrenia, must strictly adhere to their medication regimens in order to preserve treatment efficacy and avert relapse. Inadequate adherence results in elevated rates of disability, readmission, and suicide, thereby augmenting the strain on the healthcare system. Treatment efficacy, patient perception, attitudes, financial assistance, income, adverse effects, cultural milieu, therapeutic alliance, and post-treatment environment are all determinants of adherence. According to Kvarnström et al. (2021), the World Health Organization, a significant problem is the dearth of resources for mental health. Although the majority of research has concentrated on patients or their carers, there is a need for quantitative investigations to examine the role of mental health professionals in encouraging medication adherence among patients with mental illness (Semahegn et al., 2020). This paper aims to critically analyze a quantitative research article on the variables influencing medication adherence in mentally ill patients.
Quantitative Study
Wang, Y., Tong, J., Sun, X., Chen, F., Zhang, J., Yu, P., Zhang, T., Zhang, J., & Zhu, B. (2021). Analysis of Medication Adherence and Its Influencing Factors in Patients with Schizophrenia in the Chinese Institutional Environment. International Journal of Environmental Research and Public Health/International Journal of Environmental Research and Public Health, 18(9), 4746. https://doi.org/10.3390/ijerph18094746
In the context of the Chinese institutional setting, Wang et al. (2021) conducted research to investigate medication adherence and the variables that influence it in patients diagnosed who have schizophrenia. Two hundred and twenty-three individuals from the Shanghai Pudong New Area Mental Health Centre and the Tongji University School of Medicine participated in the cross-sectional investigation research. Positive and Negative Syndrome Scale (PANSS), General Self-Efficacy Scale (GSES), Schizophrenia Quality of Life Scale (SQLS), Medication Adherence Rating Scale (MARS), and Scale of Social Skills for Psychiatric Inpatients (SSPI) were some of the self-reported scales that the participants filled out during the study, which lasted from November 2018 to January 2019.
Several demographic factors, including gender, marital status, and educational level, were considered in the analysis, and the findings revealed no significant variations in medication adherence. On the other hand, there was a favorable link with self-efficacy, quality of life, and activities of daily living. The results of the linear regression analysis showed that self-efficacy, psychosocial variables, symptoms/side effects, and daily life activities had a significant influence on the degree to which individuals adhered to their prescription regimens. Self-efficacy, quality of life, and social function of patients with schizophrenia were revealed to be significant self-factors that influence medication adherence in the Chinese institutional context, according to the findings of the research. This demonstrates the need to do more study on the variables influencing medication adherence by the various mental health treatment delivery types.
Strengths
The research exhibits numerous merits. An example of this can be seen in the cross-sectional study conducted by Wang et al. (2021), which comprised 178 participants and had an approximate 20% loss to follow-up. In contrast to other kinds of observational studies, cross-sectional studies do not track individuals over time; this is one of their strengths. They are typically affordable and straightforward to execute. Preliminary evidence is a valuable ingredient in formulating strategies for subsequent advanced studies. Cross-sectional studies involve collecting data on variables for each participant at a specific moment (Skinner, 2020). This contributes to preserving the study’s findings’ validity, relevance, and credibility. It may consist of a solitary snapshot or a recurrent cross-sectional data analysis, in which the investigation is re-conducted at subsequent time intervals to track the state of affairs at a particular moment.
The study conducted by Wang et al. (2021) spanned a duration of three months, from November 2018 to January 2019. This design ensured that sufficient data was gathered to address the research inquiry. Quantitative research can accumulate enormous quantities of data significantly faster than alternative research endeavors. Real-time functionality enables analysts to integrate novel insights and modifications into their tasks without delay, thereby substantially shortening the duration of their projects. Predetermined, analytically calculated, and sufficiently large to represent the population, the sample size must be precise. Due to the heterogeneity of the population, including a larger sample size could result in wasted resources, overlooked treatment effects, and time-consuming research. It is possible that a limited sample size would fail to yield a sufficient response to the research inquiry. Professional clinical researchers additionally conducted the study, thereby validating the precision and dependability of the gathered data. An investigator gathered and assessed the sample before providing participants with instructions to complete self-reported measures in a quiet room.
The final strength is that at least 223 participants were included in the study by Wang et al. (2021), which represents a loss to follow-up of approximately 20%. The sample population is sufficiently large to mitigate potential biases in the study’s findings. As a result, the selection criteria employed to determine the sample population were suitable for ensuring the generation of valid, pertinent, and dependable results. Using a systematic sampling technique, 223 patients who satisfied the inclusion criteria were chosen. The inability of six patients to adequately complete all tests due to temporary discharge, distress, or refusal to cooperate contributed to a loss to follow-up rate of 2.69%. The study emphasizes the significance of diagnosing and treating schizophrenia in light of the underlying conditions.
Weaknesses
It is essential to acknowledge the limitations of the study conducted by Wang et al. (2021). Firstly, it is essential to note that the sample of this study is limited to one city in China. However, Shanghai serves as a suitable representation for studying the transition from “treatment criteria” to “risk criteria” due to its status as a typical city. This current finding should be regarded as preliminary and requires confirmation through additional studies. One potential limitation arises from the linguistic aspect, as the researcher initially collected the data in Chinese and translated it into English. China encounters significant research challenges due to limited secondary resources, inconsistent primary data, and a dearth of reputable companies (Hodge, 2020). Secondary data can be less reliable due to the dynamic nature of the environment. Given the conservative cultural norms and limited transparency, collecting primary data can be challenging in this context.
One final limitation of the study conducted by Wang et al. (2021) is that it is a cross-sectional study, which falls under the category of quantitative research. To gain a more comprehensive understanding of risk assessment, future qualitative studies should delve into additional details such as the evaluation process, attitudes, and other factors influencing decision-making. One limitation of cross-sectional studies is their inability to assess incidence, study rare diseases, or make causal inferences. In contrast to studies that begin with a group of patients, cross-sectional studies typically require selecting a sample of subjects from a large and diverse study population. Therefore, they are prone to being influenced by sampling bias.
Proposed Change
The study conducted by Wang et al. (2021) highlighted several limitations, as previously discussed, which offer valuable insights for future research endeavors. The current study focuses on individuals diagnosed with schizophrenia within the context of Chinese institutional settings. In the future, there is potential for conducting comprehensive analyses and comparisons of the factors influencing medication adherence across various countries and non-institutionalized settings. In addition, it is essential to note that this study has certain limitations regarding language. Specifically, the data was initially collected in Chinese and then translated into English by the researcher. The intended meaning of the participants may have been changed while being conveyed. Furthermore, it is essential to acknowledge that the study is restricted to a cross-sectional design. In future research, comprehensive studies may explore the effects of different diseases, methods of administration, types of drugs, and dosages on medication adherence. These studies may involve large sample sizes, multiple centers, and randomized controlled trials (Horne, 2020).
Implications on Nursing Practice
The study conducted by Wang et al. (2021) sheds light on the specific challenges associated with medication nonadherence among individuals suffering from severe mental disorders, such as schizophrenia, in China. It is recommended that psychiatrists and nurses prioritize the establishment of therapeutic alliances with patients and their families. This will enable them to effectively identify patients’ insights and promptly address any treatment side effects that may arise. Efforts should be made to enhance psychoeducation regarding mental disorders and treatment in order to minimize misconceptions. It is recommended that governments establish mental health services at the local community level and share successful mental health models with other regions. Efficient implementation of mental health models can be achieved by integrating the mental health workforce at all levels (Baghdadi et al., 2023). By following these steps, the mental health system of the future can enhance medication adherence in individuals with severe mental disorders and alleviate the economic burden for patients and society in China.
Conclusion
Quantitative research is commonly employed to record prevalence rates and rigorously examine hypotheses accurately. The selected quantitative study was conducted in China and focused on the impact of self-efficacy, quality of life, and social function on medication adherence among patients with schizophrenia. Nevertheless, no significant link was found between medication adherence and demographic factors or mental symptoms. The study found that medication adherence positively correlated with self-efficacy and daily living activities but negatively correlated with psychosocial factors and symptoms. The hospitalization mode may impact the study’s findings for patients within the Chinese institutional environment.
References
Baghdadi, N. A., Alotaibi, T., & Abdelaliem, S. M. F. (2023). Assessing the quality of nursing clinical placement: A quantitative cross‐sectional study. Nursing Open, 10(9), 6143–6149. https://doi.org/10.1002/nop2.1836
Hodge, S. R. (2020). Quantitative research. In Routledge eBooks (pp. 147–162). https://doi.org/10.4324/9780429052675-12
Horne, R. (2020). Medication adherence: A review of existing research. CRC Press eBooks, pp. 285–310. https://doi.org/10.1201/9781003072348-15
Kvarnström, K., Westerholm, A., Airaksinen, M., & Liira, H. (2021). Factors Contributing to Medication Adherence in Patients with a Chronic Condition: A Scoping Review of Qualitative Research. Pharmaceutics, 13(7), 1100. https://doi.org/10.3390/pharmaceutics13071100
Semahegn, A., Torpey, K., Manu, A., Assefa, N., Tesfaye, G., & Ankomah, A. (2020). Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: a systematic review and meta-analysis. Systematic Reviews, 9(1). https://doi.org/10.1186/s13643-020-1274-3
Skinner, C. J. (2020). Quantitative research. In Routledge eBooks (pp. 215–224). https://doi.org/10.4324/9781003070993-21
Wang, Y., Tong, J., Sun, X., Chen, F., Zhang, J., Yu, P., Zhang, T., Zhang, J., & Zhu, B. (2021). Analysis of Medication Adherence and Its Influencing Factors in Patients with Schizophrenia in the Chinese Institutional Environment. International Journal of Environmental Research and Public Health/International Journal of Environmental Research and Public Health, 18(9), 4746. https://doi.org/10.3390/ijerph18094746
ORDER A PLAGIARISM-FREE PAPER HERE
DNP graduates are expected to apply research findings and integrate nursing science into evidence-based practice. To develop your skills in this high level of nursing practice, you will analyze the strengths and weaknesses of a research study over the next several weeks using the concepts presented throughout the course. Your final analysis will be a 5- to 7-page paper that includes the following:
- A brief, 1- to 2-paragraph overview of the quantitative study that you selected. FOR THE PURPOSE OF THIS ASSIGNMENT THE ARTICLE CANNOT BE A SYSTEMATIC REVIEW. Review the Walden University library information on a systematic review https://academicanswers.waldenu.edu/faq/145443Links to an external site.
- An explanation of two to three strengths of the study and support for your selection (i.e., why is this a strength). Be specific.
- An explanation of 2–3 weaknesses of the study and support for your selection (i.e., why is this a weakness). Be specific.
- Note: The strengths and weaknesses that you identified should be in relation to design, sampling, data collection, statistical analysis, results, and discussion of the study that you selected.
- An explanation of proposed changes you would recommend to improve the quality of the this quantitative study, capitalizing on the strengths and improving on the weaknesses that you identified in the study. Be specific and provide examples.
- A final summary of the implications of this study for nursing practice.
The purpose of the analysis is to help you develop a deeper understanding of the research process, to inspire you to think critically and deeply about research on a specific topic, and to strengthen your ability to integrate research findings into evidence-based nursing practice. This Assignment also gives you practice in analyzing the research literature, which will support you when you begin your DNP project. Before you proceed, please review the rubric for this Assignment.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEK 10: LEARNING RESOURCES
Required Readings
- Bradshaw, B., Atkinson, S., & Doody, O. (2017). Employing a qualitative description approach in health care researchLinks to an external site.. Global Qualitative Nursing ResearchLinks to an external site., 4, 1–8. doi:10.1177/2333393617742282
- Doyle, L., McCabe, C., Keogh, B., Brady, A., & McCann, M. (2020). An overview of the qualitative descriptive design within nursing researchLinks to an external site.. Journal of Research in Nursing, 25(5), 443–455. doi:10.1177/1744987119880234
- Kim, H., Sefcik, J. S., & Bradway, C. (2017).Characteristics of qualitative descriptive studies: A systematic reviewLinks to an external site.. Research in Nursing and Health, 40(1), 23–42. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225027/
- Morgan, D. L. (1997). Focus groups as qualitative researchLinks to an external site.(2nd ed.). SAGE Publications, Inc. https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.4135/978141298
- Ramos-Morcillo, A. J., Harillo-Acevedo, D., & Ruzafa-Martinez, M. (2020). Using the Knowledge?to?Action Framework to understand experiences of breastfeeding guideline implementation: A qualitative study.Links to an external site.Journal of Nursing Management, 28(7), 1670–1685. doi:10.1111/jonm.13123
- Springer, S. I., Land, C. W., Moss, L. J., & Cinotti, D. (2018). Collecting school counseling group work data: Initiating consensual qualitative research through practitioner-researcher partnershipsLinks to an external site.. Journal for Specialists in Group Work, 43(2), 128–143. doi:10.1080/01933922.2018.1431346
Required Media
- Brett, B. M. (2021). What interviewing style should I use?Links to an external site. [Video]. SAGE Research Methods. https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.4135/9781529763126
- Wheeler, K. (2021). What is an in-depth interview?Links to an external site. [Video]. SAGE Research Methods. https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.4135/9781529763119
- Wheeler, K., & Brett, B. M. (2021). Top ten tips for a successful interviewLinks to an external site.[Video]. SAGE Research Methods. https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.4135/9781529763195
- Hein, W. (2020). Top tips for conducting qualitative researchLinks to an external site. [Video]. SAGE Research Methods. https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.4135/9781529730708
- Marshall, C., & Rossman, G. B. (2011). How should one go about designing a qualitative research project?Links to an external site. [Video]. SAGE Research Methods. https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.4135/9781412993746
- Marshall, C., & Rossman, G. B. (2011). When should a researcher choose a qualitative approach?Links to an external site. [Video]. SAGE Research Methods. https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.4135/9781412993753
THE ASSIGNMENT: (5–7 PAGES)
- Select a quantitative research article from the body of literature that you have reviewed related to the practice gap that you have identified and for which you will develop for your DNP Project.
- Review the various quantitative research designs presented in the textbook readings and research articles.
- Consider the research design used in your selected article. Ask yourself the following questions:
- Is the design appropriate for the study? Why or why not?
- Would a different design provide better results? Why or why not?
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632Links to an external site.). All papers submitted must use this formatting.
BY DAY 7
Submit your Assignment by Day 7 of Week 10.
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
- To submit your completed assignment, save your Assignment as WK10Assgn2+last name+first initial.
- Then, click on Start Assignment near the top of the page.
- Next, click on Upload File and select Submit Assignment for review.
Rubric
NURS_8201_Week10_Assignment2_Rubric
| Criteria | Ratings | Pts | ||||
|---|---|---|---|---|---|---|
| This criterion is linked to a Learning OutcomeWrite a 1- to 2-paragraph overview of the study selected. |
|
25 pts | ||||
| This criterion is linked to a Learning OutcomeExplain two to three strengths of the study and support for your selection. Be specific.Explain two to three weaknesses of the study and support for your selection. Be specific. |
|
80 pts | ||||
| This criterion is linked to a Learning OutcomeExplain the proposed changes that you would recommend to improve the quality of the study. Capitalize on the strengths to improve on the weaknesses. Be specific and provide examples. |
|
100 pts | ||||
| This criterion is linked to a Learning OutcomeWrite a final summary of the implications of this study for nursing practice. |
|
50 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. |
|
15 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation |
|
15 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. |
|
15 pts | ||||
| Total Points: 300 | ||||||